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Although the only major team sport to involve no body contact, volleyball entails long hours of intensive training sessions and competition that can result in significant changes to the musculoskeletal system, thereby placing the players at a higher risk for injuries.
The incidences of musculoskeletal injuries in volleyball players can be mainly linked to the complexity of the game in terms of rapid lateral movements combined with repetitive ballistic actions such as blocking or spiking the ball, both of which involve vertical jumps.
Acute and overuse injuries are common in volleyball players, with these types of injuries reported to occur as often as chronic injuries; the ankle, knee and shoulder are observed to be the most frequent sites of injury.
Ankle sprains represent the most common form of acute injuries incurred by volleyball players; these often happen at the net due to unsafe blocking or striking methods, making the middle-, left- and right-side hitters susceptible to these sprains.
As stated by Lachlan James, from the School of Human Movement Studies at the University of Queensland, the primary mechanism for ankle injuries is a spiking strategy at a trajectory that displaces the athlete on or over the centre line, resulting in foot contact with an opponent beneath the net.
In addition to this, incorrect lateral movement and take-off technique can cause the athlete to land on the foot of a teammate, leading to ligamentous injuries of the ankle.
The prevalence of patellar tendinopathy or “jumper’s knee” in elite volleyball players was explained in detail by Johannes Zwerver who attributed the condition to a reduced loading capacity which makes an athlete less capable of generating or absorbing forces, ultimately resulting in a wrong jumping and/or landing technique.
The author lists out risk factors for the condition as reduced strength of calf, quadriceps and gluteal muscles, inadequate core stability, reduced hamstring and quadriceps flexibility and hyperpronation of the foot.
A hyperpronated foot causes an excessive internal rotation of the ipsilateral tibia, which leads to an excessive internal rotation of the ipsilateral femur as well.
This counter-rotation of the femur and tibia causes an increase in the Q-angle.
The foot and ankle complex is seen to dorsiflex and abduct, causing the knee and subsequently the hip to flex, adduct and rotate internally.
The result of this compensatory abnormality is an ipsilateral pelvic tilt.
Prolonged exposure to the resultant excessive forces created by the ineffectiveness of the foot function combined with the aberrant tracking of the knee, can produce chronic inflammation and joint degeneration, which manifests in the form of patellofemoral pathology.
A comprehensive injury prevention plan designed to protect athletes from the onset of musculoskeletal injuries needs to include proprioceptive and strength exercises in conjunction with a dynamic warm-up within training sessions and games.
This was proven by James et al. who (over a seven week period) assigned six trained subjects to one of two groups: an intervention group performing combined prehabilitation and resistance training or a control group performing resistance training only.
A positive effect was recorded on lower body strength with prehabilitation when combined with periodised resistance training, reinstating the fact that the warm-up is an effective time for integrating injury prevention strategies without attenuating strength and power development.
Building strength in muscles of the lower extremity can further be accomplished by addressing biomechanical discrepancies such as a hyperpronated foot with the use of foot orthotics such as MASS4D® that are customised according to individual specifications and needs.
By applying the greatest corrective support to the plantar surface of the foot, MASS4D® facilitates healthy supination balanced with functional pronation; this enhances an even distribution of soft tissues, boosting proprioception capabilities and optimising joint alignment.
This is the reason for the success of MASS4D® orthotics in active rehabilitation programmes and for treating lower extremity biomechanical faults to enhance the athlete’s performance and to prevent recurrences of injuries.
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